| NPI | 1700668167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL NEVADOMSKI Secretary/Practice Manager 516-204-3196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| 101Y00000X Counselor | |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2024-01-31 |